<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8">
<title>Форма</title>
<link href="css/style_background.css" type="text/css" rel="stylesheet">
<style>
	p, label, legend{
	font:16px Verdana;
	}
	fieldset{
	border:1px solid #cc0000;
	width:500px;
	}
</style>
</head>



<form  method="post" action="print.php">
<div id="wrapper" style="margin:20px 200px;">
	<fieldset>	
	<legend>Личная информация</legend>
	<p><label for="text1">ФИО</label>
		<input type="text" name="FIO" id="text1" size="60">
	</p>
	
	<p><label for="text2">Адрес</label>
		<input type="text" name="address" id="text2" size="60">
	</p>
	
	<p><label for="code">Код</label>
		<input type="password" name="code" id="code" size="6">
	</p>
	
	<p>Дата рождения
		<select name="day">
			<option>1</option>
			<option>2</option>
			<option>3</option>
			<option>4</option>
			<option>5</option>
			<option>6</option>
			<option>7</option>
			<option>8</option>
			<option>9</option>
			<option>10</option>
			<option>11</option>
			<option>12</option>
			<option>13</option>
			<option>14</option>
			<option>15</option>
			<option>16</option>
			<option>17</option>
			<option>18</option>
			<option>19</option>
			<option>20</option>
			<option>21</option>
			<option>22</option>
			<option>23</option>
			<option>24</option>
			<option>25</option>
			<option>26</option>
			<option>27</option>
			<option>28</option>
			<option>29</option>
			<option>30</option>
			<option>31</option>
		
		</select>
		
		<select name="month">
			<option>1</option>
			<option>2</option>
			<option>3</option>
			<option>4</option>
			<option>5</option>
			<option>6</option>
			<option>7</option>
			<option>8</option>
			<option>9</option>
			<option>10</option>
			<option>11</option>
			<option>12</option>
					
		</select>
		
		<select name="year">
			<option>1984</option>
			<option>1985</option>
			<option>1986</option>
			<option>1987</option>
			<option>1988</option>
			<option>1989</option>
			<option>1990</option>
			<option>1991</option>
			<option>1992</option>
			<option>1993</option>
			<option>1994</option>
			<option>1995</option>
								
		</select>
	</fieldset>	
	
	<fieldset>	
		<legend>Место рождения</legend>
		<p><label for="city">Город</label>
			<input type="text" name="city" id="city">
		</p>
		
		<p><label for="region">Область</label>
			<input type="text" name="region" id="region">
		</p>
		
		<p><label for="country">Страна</label>
			<input type="text" name="country" id="country">
		</p>
	</fieldset>
	
	<fieldset>		
	<legend>Знание языков</legend>
		<p>Я знаю
			<input type="checkbox" name="language[]" value="Italian" checked>Italian
			<input type="checkbox" name="language][]" value="French">French
			<input type="checkbox" name="language[]" value="Spanish">Spanish
			<input type="checkbox" name="language[]" value="German">German
		</p>
	</fieldset>	
	
	<fieldset>
	<legend>Деятельность</legend>	
		<p>Профессионал
		<input type="radio" name="profession" value="profi">
		</p>
		<p>Новичок
		<input type="radio" name="profession" value="newbie">
		</p>
	</fieldset>	
	
		<p>Резюме</p>
		<p>
			<textarea name="resume" rows="10" cols="40"></textarea>
		</p>
		
		<input type="submit" value="Отправить">
		<input type="reset">
	</div>
</form>
</html>